Couse
congenital
Rare
Cloaca.without spongiofibrosis
inflammation
Urethritis without treatment
Bulbar. Long and multiple stenosis
Balanitis xerotica obliterans Lichen sclerosis
ischemic
Heart surgery 22%
Penile
Suprapubic. small caliber
truma
Blunt. Straddle. partial
Penetrating.bullet.primary.delay
Iatrogenic.The most common Couse
.penoscrotal .meatus
Pelvic fx
Pelvic fracture�
10% with urethral injury
Membranoprostatic junction
Partial =catheter. low incidence of stricture
Complete=surgery anastomosis
ED because trauma not surgery
diagnosis
RUG.AUG
Sonography
MRI
Endoscopy
Treatment
endoscopic
anastomotic
replace
Endoscopic�urethral dilation�
Endoscopic �internal urethrotomy
CIC
Anastomotic urethroplasty
Anastomotic urethroplasty
contraindicate
2 cm
regardless of length
Substitution urethroplasty
Recurrence
Success in 4 y :60%
URETHRAL STENT
Bulbar urethra
Mild and short stenosis
Success 50%
not recommended for young people and fibrosis and penile urethra
Meatal stenosis
Penile urethra stricture
The best and only method substitute urethroplasty
Bulbar urethra stricture
Less than 2 cm anastomotic
more than 2 cm substitute
Posterior urethra stricture
Pelvic fracture . Post prostatectomy
If surgery is required for other reasons, such as rupture of the rectum or bladder neck, initial repair and hematoma drainage
Classic treatment includes cystostomy and delayed repair with open surgery three to six months later with 95% success.